{
  "abstract": "Background Medication adherence is critical for children with liver disease, crucially for those taking immunosuppressant medications post liver transplantation. Prevalence of non-adherence in children and young people (CYP) post transplantation is reported to be as high as 40% and is one of the leading modifiable factors associated with organ loss and mortality. 1 There are no tailored tools enabling health care professionals (HCP) to assess the risk of non-adherence which addresses the unique needs of CYP. The ‘Making Medicines Work for You’ (MMWFU) adherence screener is a tool currently used in adult practice to improve the identification and discussion of medication adherence.Aim To evaluate the acceptability and feasibility of an adapted ‘Making Medicines Work for You’ (MMWFU) adherence screener for CYP with liver disease and their caregivers. To evaluate the level of self-reported adherence within children with liver disease and describe the reported risks associated with non-adherence.Methods A mixed-methods, cross-sectional evaluation was conducted at a quaternary paediatric liver centre over 6 months. Families of children aged 0–16yrs with liver disease were invited to complete a questionnaire exploring demographic and clinical characteristics, complete the MMWFU screener, self-reported adherence levels were recorded per medicine via Visual Analog Scale (VAS), MMWFU screener acceptability was assessed using the Theoretical Framework of Acceptability (TFA).Results 61 caregivers completed the evaluation and MMWFU screener, patients ages ranged from 5 months – 16 yrs. Biliary atresia was the most reported type of liver disease (31.1%), 52.5% of patients had received a liver transplant. Patients reported on average taking 3 medicines (range 1-8). 45/61 respondents completed self-reported medication adherence data, with a mean rate of 91.7%. Patients taking tacrolimus had a self-reported adherence rate of 98%.42/61 respondents identified at least one medicine related issue on completing the MMWFU screener. The top three statements ticked by respondents were 1) My child sometimes forgets to take their medicines, 2) my child find(s) their medicine difficult to use 3) my child has some worries about their medicines.The screener was rated as ‘acceptable’ or ‘completely acceptable’ by 78.7% of participants. Participants highlighted its value facilitating medication adherence discussions with HCP; suggested improvements included simplified language and a digital format.Conclusion The MMWFU screener was well-received, demonstrating potential to support adherence discussions and provides a foundation to develop tailored tools to improve medication adherence in CYP with liver disease and their caregivers. High levels of self-reported adherence were reported in our cohort, especially in those taking tacrolimus, future studies including objective adherence measures alongside self-reported measures, would provide a more comprehensive assessment of adherence. Despite this a number of risks associated with non-adherence were identified on completing the screener, highlighting potential areas to develop tailored interventions for CYP. Further studies are required to validate the MMWFU adherence screener in practice and assess impact on long-term outcomes.References Shemish E, Schneider BL, Savitzky JK et al. Medication adherence in pediatric and adolescent liver transplant recipients. Pediatrics 2004;4:825–32.Weinman J, Ali I, Hodgkinson A et al. Pilot Testing of a Brief Pre-Consultation Screener for Improving the Identification And Discussion Of Medication Adherence In Routine Consultations. Patient Prefer Adherence 2019;13:1895–1898.Sekhon M, Cartwright M, Francis J et al. Development of a theory-informed questionnaire to assess the acceptability of healthcare interventions. BMC Health Services Research 2022;1:279.",
  "authors": [
    {
      "affiliations": [
        "Kings College Hospital NHS Foundation Trust, UK"
      ],
      "name": "Joanne Crook"
    },
    {
      "affiliations": [
        "Kings College London, UK"
      ],
      "name": "Tasniya Aktar"
    },
    {
      "affiliations": [
        "Kings College London, UK"
      ],
      "name": "Assya Mol Veluthedathparambu Subair"
    },
    {
      "affiliations": [
        "Kings College London, UK"
      ],
      "name": "Sarah Chapman"
    }
  ],
  "title": "P50 ‘Making medicines work for you’ adherence screener in children with liver disease",
  "uid": "690abc57-ef74-5038-8bf0-086b98f0fa6f"
}